AIDS

The other war

George Bush's pledge of more money to fight AIDS should be welcomed

IN HIS state-of-the-union address, George Bush may have stopped short of declaring war on Saddam Hussein, but he did declare war on an even more insidious (and less controversial) enemy: HIV, the virus which causes AIDS. Mr Bush promised to fight this battle in more than a dozen African countries, as well as parts of the Caribbean, with $15 billion ($10 billion of it new) over the next five years. Congress willing, this will be enough, he argues, to prevent 7m new infections, to treat 2m infected people with anti-retroviral drugs and to care for 10m HIV-infected people and AIDS orphans.

Such largesse has, for the moment, silenced recent criticism that America had not contributed enough to the global struggle against poverty and disease. AIDS is arguably the world's worst health crisis, and Africa is undoubtedly its most hapless victim. More than 29m Africans are now infected with HIV, and the disease kills more Africans than all the continent's wars combined—2.4m last year. It strikes down adults in their productive prime, leaving orphaned children and limping economies in its wake. Until this week, many people were outraged that America had offered only $500m to a “Global Fund to fight AIDS, Tuberculosis and Malaria”, set up in 2001 to take on this microbial axis of evil. Now, Mr Bush says the Fund will receive $1 billion of the new money, with the rest going to private groups and “willing governments” in target countries to diagnose, prevent and treat AIDS.

Cynics may scoff that bankrolling this worthy cause is merely a ploy to win friends at a time when America wants allies but has few firm ones. More malign critics may see it as a tactic to prop up American drug firms, which are worried by African demands at the World Trade Organisation for wider access to generic medicines. We cannot know whether such motives played a part, but it could also be that Mr Bush was persuaded that AIDS is a crisis that craves his attention.

A more important question is how the cash should be spent. There is no shortage of sensible plans. More anti-retroviral drugs are needed, to prevent mothers from infecting their unborn children, and to keep infected people healthier and less infectious. Other, often cheaper drugs are needed to treat associated infections. More investment is needed in medical infrastructure and manpower; without diagnostic equipment to find out who needs them, or medical staff to administer them, drugs do little good. More must also be done to curb the virus's spread. An effective vaccine would be wonderful; meanwhile there should be safe-sex campaigns and efforts to de-stigmatise AIDS, so that more people get tested.

Not too many strings, please

Mr Bush's cash should boost existing efforts, and perhaps inspire other rich countries to stump up more. It is a pity that more has not been promised to the Global Fund, which has valuable expertise in helping poor countries help themselves, but is short of cash. Mr Bush clearly prefers America to decide for itself how American money is spent. Fair enough, but not if too many strings are attached.

Mr Bush has already barred the distribution of American money to organisations deemed to promote abortion, which has hobbled a number of reproductive-health charities. Some American officials have even said that they disapprove of condoms, perhaps the single most important barrier to the spread of AIDS. Mr Bush should ignore them. America's concerns about patents are valid, but some exceptions should be made for the use of copycat AIDS drugs in poor countries.

Even with unlimited resources, the war on AIDS would be tough. The African countries on Mr Bush's list are among the better-governed ones, but most are hard to work in, and Côte d'Ivoire is in chaos. This is not a fight, however, that can be shirked. AIDS has helped to create “failed states” in Africa, which could one day harbour terrorists. More importantly, there are millions of lives to be saved, and America has the money to save them. So do others, mind you.